HOMILÍA DEL SANTO PADRE FRANCISCO (8.IV.18)

Introduction

This project was intended to develop an innovative academic policy to transform

a university’s nursing programs from a traditional content-based to a concept-based

curriculum model through the creation of a policy paper. A writer of a policy paper

develops a workable plan of action for addressing a problem through critical analysis and

research (Foster, 2007). In order to propose change to existing policies and practices in a

university setting, I required an intensive understanding of all stakeholder viewpoints,

policy and practice restrictions, and accrediting body requirements, as well as full

understanding of the decision making process within the university. I adhered to all of

these constraints as I composed the complete policy paper, located in Appendix A of this

document.

In Section 3, I outline the project and creation of the policy paper, as well as the

goals of the project. I also provide a rationale for the project, supported by a literature

review. Finally, I outline the implementation and implications of the study and the policy

paper.

Description and Goals

Identifying the goals for this project was paramount to understanding the policy

paper’s scope and delineation. Three goals were set for this project:

• Educate stakeholders about concept-based learning and why a university should adopt this learning method for their nursing programs

• Develop a policy paper that addresses an action plan for nursing program conversion to a concept-based learning curriculum at a university nursing

program in Central Florida

• Share the study results on concept-based learning with university stakeholders. These goals guided the creation of the policy paper in its entirety and proposed next steps

for achieving the goals’ fulfillment.

In order to create the policy paper, I first identified major stakeholders involved in

the nursing curriculum development problem, including campus administrators, nursing

directors, faculty, and corporate officers. These identified stakeholders’ had the ability

and authority to make decisions within the university. The project requires all

stakeholders to maintain an open mind through the change process. Administrators and

corporate officers have been included as stakeholders because their support with financial

backing was crucial in affecting institutional change (Patria, 2012). Approval and

adoption of a policy change can occur by the identified stakeholders. This step was

necessary to ensure that the policy paper reached those who would have the most

influence in enacting evidence based change.

Once I identified stakeholders, I analyzed the situation to best present the

evidence to this audience. The identified problem was clearly defined to the nursing

directors and faculty allowing them to accept the change (DuFour, 2011), when presented

with evidence-based information. I constructed the paper to be comprehensive and

educational in order to best present the information to administrators and corporate

additional scholarly information concerning the improvement of nursing students’ overall

academic achievement.

The results supported the implementation of a concept-based curriculum at the

university under study. One of the major concerns for nursing faculty and administrators

in converting to concept-based learning was, the fear that the NCLEX-RN exam pass rate

would decrease. The study results on whether nursing students’ had improved their

NCLEX-RN scores, provided evidence to the contrary. In addition, the overall academic

achievement data for student performance on additional standardized exams, the

Diagnostic and Readiness exams, showed that the curriculum structure was solid and that

implementation would not require a complete overhaul. The concept-based curriculum

policy paper will provide stakeholders with a convincing tool for the university’s

adoption of this curriculum. The implementation portion of this section will provide

additional details of this presentation.

In line with the NLN’s (2005) and the IOM’s (2003) call for nursing education

reform, the study results showed that the concept-based curriculum improved nursing

student academic achievement. The use of the study results was a starting point in

establishing a university policy that would require the nursing programs to adopt a

concept-based learning curricula model over a traditional content-based model. The

following section will provide the rationale for the project and a specific discussion of its

findings.

Rationale

Nurse educators and stakeholders in nursing education are acutely aware of the

convey the study’s findings and advocate evidence based change in university policy and

instructional practice to reflect a concept-based curriculum’s implementation. The data

analysis, based on exam results from nursing graduates between the years of 2009-2014,

combined with an extensive literature review on concept-based curriculum, helped

characterize the project for this research study. The findings supported the premise that a

concept-based learning curriculum would improve student academic achievement. I

constructed a policy paper in order to explain this change, according to an extensive

review of literature related to this genre.

Review of the Literature

Based on the data collected related to concept-based curricula in a nursing

program, the purpose of this literature review was to establish the effectiveness of using a

policy paper in communicating a policy change plan and examining change management

principles as it relates to organizational change. I applied these findings to the

recommended implementation of the curricular change within a nursing program.

Using Walden University Library resources, including ERIC, CINAHL,

ProQuest, EBSCO, and Google Scholar, a complete data base search occurred. During

this literature review, I used over 20 combinations of terms using Boolean operators;

strategic words used were policy paper, policy paper purpose, policy paper components,

how to write a policy paper, policy paper in organizational change, change, change management, and curriculum change in higher education. Sources concerning policy

paper development were minimal when compared to the topic of change management.

policy paper, best practices for constructing a policy paper and theoretical and research

support.

Purpose of a Policy Paper

The purpose of a policy paper is to present a comprehensive and convincing case

supporting the policy recommendations proposed in the paper, and therefore represent

itself as a policy-making tool and a call to action for the identified stakeholders (Foster,

2007; Young & Quinn, 2012). As a policy-making tool, the policy paper’s initial purpose

is to define an urgent policy issue within the current policy framework. A policy paper

can identify and address outlined issues making them understandable. The process found

when developing a policy paper are to recommend and define key options, provide an

analysis of possible outcomes of these options, make policy recommendations, and

provide a strong argument for why this policy option is the best course of action

(National Collaborating Centre for Methods and Tools, 2011). Through these aspects,

the policy paper comprises a workable plan of action for stakeholders (Foster, 2007).

Young and Quinn (2012) stated that the policy paper is problem and solution

focused, thus creating the impetus for a particular policy change. Policy papers publish a

viewpoint, address an issue through the decision making process, or have a positive

influence on a particular community when based on evidence (Strauss, 2013; Vardiman,

Shepard, & Jinkerman, 2014). The focus on present situations precludes the inclusion of

historical analysis, case studies, opinion, description, or an analysis of how something

might work (Scotten, 2011). In essence, the policy paper’s purpose is as a convincing

tool to shift stakeholders’ opinions toward the desired change (Scotten, 2011; Strauss,

Wallis (2010) noted that the internal and external stakeholders define the policy

paper’s process (representation, implementation, and measurement). The writer of a

policy paper must develop a clear understanding of the purpose of and audience for a

policy paper to be effective in conveying a message successfully, so that the stakeholders

will endorse the intended recommendations (Strauss, 2013; Wallis, 2010). Mundt, Clark,

and Klemczak (2013) described in their study how using the policy paper model was able

to bring about a policy change in nursing education throughout the state of Michigan.

Overall, all of the authors and websites explaining the purpose of this genre

agreed that an effective policy paper succinctly identifies and summarizes a problem and

clearly defines a solution through the development of a policy (Foster, 2007; Scotten,

2011; Young & Quinn, 2012). Additionally, understanding the targeted stakeholders and

considering their perspectives provides an effective convincing tool (Strauss, 2013;

Wallis, 2010). Therefore, the policy paper included in Appendix A provides a medium to

communicate and direct stakeholders to advocate for the proposed policy change of

implementing a concept-based curriculum at all nursing programs at a given university.

Theoretical Beginnings

Taylor and Machado-Taylor (2010) wrote that the use of planning when

considering a policy change within an organization might refute the resistance to the

transformation. Thus, considering all aspects of the policy paper prior to its creation was

a key component of the construction of the policy paper. Many researchers suggested

that constructing a policy paper begins with a solid theoretical underpinning (Breton &

Leeuw, 2010; Vanderlinde, Braak, & Dexter, 2011). Breton and Leeuw (2011) stated

direction of analytical policy analysis. Theoretical underpinnings in a policy paper set

the stage for how, why, and who should be involved in the change (Vanderlinde et al.,

2011).

For my policy paper, the theory of change management shaped the development

of each individual section of the policy paper (Barkenbus, 1998). Specifically,

Baumgartner, Jones, and Veible (2007) described how a single theory called punctuated

equilibrium theory (PET) provides change, stability and policy development into one

source. This theory prevents having to use multiple theories when developing a policy

statement (Baumgartner et al., 2007). Nowlin (2011) collaborated that PET is evolving

into an all-encompassing theory based on acknowledging long periods of change and

stasis within the policymaking process.

PET involves several key concepts that I utilized in the creation of the policy

paper, including bounded rationality, framing, and policy monopolies (Cairney, 2013).

Bounded rationality involved the limited attention that stakeholders can afford to

addressing issues; framing described the way that a problem is articulated and

subsequently solved; and policy monopolies are the preferred methods of framing an

issue that may be taken for granted because of their ubiquity (Cairney, 2013). For the

purposes of understanding nursing education reform, a policy monopoly existed

regarding evaluating reforms in terms of evaluating first-time pass rates on the NCLEX-

RN and meeting the call of the IOM (2003) and the NLN (2005) for nursing education

reform. I worked within this framework to structure the curriculum reform, as an

ongoing and significant issue of how using concept-based curricula is addressed, based

and easily implemented plan for change to suggest that implementation was a workable

solution for stakeholders. After working through these theoretical underpinnings, I began

constructing the policy paper.

Constructing a Policy Paper

When researching the literature regarding the form of a policy paper, I noted that

no accrediting body or organization has taken ownership for creating the standards for

writing a policy paper. However, published descriptions and guidelines that established a

form for policy papers existed on university websites, in journal articles, and in course

books (Barkenbus, 1998; Foster, 2007; Scotten, 2011; Young & Quinn, 2012). These

resources provided several guidelines for constructing an effective policy paper.

Several models showed different ways to construct a policy paper, but when

reviewed, I determined that the differences were only superficial. Tonn and Peretz (1998)

identified three stages in the policy making cycle that included 1) identify alternatives, 2)

gather and analyze alternatives, and 3) apply a decision tool. Barkenbus (1998) described

the process having four stages 1) agenda setting, 2) policy foundation, 3) policy

implementation, and 4) policy evaluation. While different methods to the policy creation

process exist, depending on the context and purpose, the course book model (Figure 2;

Young & Quinn, 2002) recognized the policy science model is what grounds this policy

Figure 2. Policy cycle. Adapted from Writing Effective Public Policy Papers: A Guide to Policy Advisers in Central and Eastern Europe, by E.Young & L. Quinn (2002).

Budapest, Hungary: Local Government and Public Reform Initiative.

The policy cycle follows a recursive process of evidence-based decision-making.

The culminations of policy paper research and design recommendations fundamentally

underpinned the creation of this policy paper. Opportunities during the policy cycle

process for reflection and evaluation could occur.

Pennock (2011) stated that policy papers vary in length from 1 to 100 page

documents. Policy papers commonly incorporate common components: an executive

summary; statement of the problem/issue; background information; identified

stakeholders; alternative options; and recommendations for action (Pennock, 2011).

Problem Definition/Agenda Setting Constructing the Policy Alternative/Policy Formation Choice of Solution/Selection of Preferred Policy Option Policy Design Evaluation Policy Implementation and Monitoring

Additional components found to be included in a policy paper are how to implement the

policy, cost-benefit analysis, and an evaluation plan (Teirlinck, Delandhe, Padilla, &

Verbeek, 2012). Utilization of the seven-section policy model for this paper, which

begins with an introduction and background of the issue, followed by a statement of the

problem and subsequently, current policies and alternative solutions. Following the

explanation of the current state of the problem, the writer of the policy paper

recommends a new strategy and demonstrates how implementation can occur and why

the solution is feasible. The policy paper ends with a conclusion and references (Young

& Quinn, 2012).

Introduction and background of issue. This section addresses the identified

social issue along with additional background information concerning the problem

identified (Hall, 2011). It includes such content as how the issue originated, the

importance of the issue, what ethical or scholarly issues accentuate the importance of the

concern, and why should society be concerned with the issue (Hall, 2011). DeMarco and

Tufts (2014) stated that this section should advance from the general to the exact and not

be excessively technical to where the reader would have a hard time understanding the

purpose. Boston University (2015) and Hall (2011) wrote that the paper should address

the historical aspects of the issue as well as the efficacy. Key stakeholders in previous

policy implementations should also be addressed (Boston University, 2015). Overall, this

section reviews the issue and current solutions, which may be effective or ineffective.

Statement of the problem. The statement of the problem section’s purpose is to

examine the identified issues found in the background and determine if they are related.

reflects a need for a policy change; which critical populations are affected by the

problem; a detailed and defined statement of the problem; and what chief causes effect

the problem (Hall, 2011; Lavis et al., 2012; York University, 2015). The description of

the problem sets the focus of the policy to be proposed (Nannini & Houde, 2010). The

overall focus of this section defines the key questions, ethical reasoning, and arguments

that are associated with the identified problem (Felce & Purnell, 2012).

Current policies. This area of the policy paper focuses on identifying existing

policies or programs that influence the problem. This section addresses the problem, and

whether existing policies correct, exacerbate, or have no effect on it (York University,

2015). Stakeholders and their support for current policies should be determined in the

current policies section (York University, 2015). A vigorous discussion of the

weaknesses or limitations of the current policy will set the stage for the new policy.

Alternative solutions. This section analyzes two or three alternate solutions for

the problem (Nannini & Houde, 2010). These solutions should be complete and

considered viable options for the problem without bias being interjected (Freeman &

Maybin, 2011). Current policy or a modified version is always a possible alternative and

should be included within the presentation of options (Boston University, 2015). Each

alternative solution or option should include its strengths and weaknesses, which

stakeholders endorse or object, and if it is a new solution, why it has not been

implemented (York University, 2015).

Policy recommendations, feasibility, and implementation strategies. The

focal point of the recommendations section involves originating an operative policy

demonstrating that the proposed solution will work (Barkenbus, 1998; Harris & Burns,

2011; Vardiman et al., 2014). DeMarco and Tufts (2014) suggested that the writer use

active voice, familiar language, and action-based statements to facilitate change. The

recommended policy should provide a clear argument of why the chosen policy is the

best choice (Nannini & Houde, 2010). A detailed recommendation plan on when and

how to implement the primary policy option should be included (York University, 2015).

Additional areas that can be found in this section are cost-benefit analysis, evaluation

criteria, and predictions on what will likely happen if this option is adopted (Boston

University, 2015; Teirlinck et al., 2012). In all, the recommendations section works to

frame the solution and provide a clear, feasible argument for the solution to stakeholders.

Conclusion. The conclusion is considered the capstone of the policy paper

(Flanagan, Ulyarra, & Laranja, 2011; Freeman & Maybin, 2011). It should summarize

the argument with a final plea to the stakeholders to adopt the main policy option. The

conclusion should present the argument in miniature and demonstrate a final,

impassioned plea for the solution to be adopted (Flanagan et al., 2011).

References. The reference section should include all citations and any other

background resources used within the paper. The reader should be able to find the

references easily when more information or clarification of information is needed

(Boston University, 2015).

Theoretical and Research Support

The project is based on changing university policy concerning the type of

curriculum nursing programs will use, based on the results of the quantitative

archival data from a nursing school that had provisionally implemented a concept-based

curriculum in the 2011-2012 semester. The IRB approval number for this study was 01-

23-15-0015606.

The policy paper proposes that the school change entirely to a concept-based

curriculum based on the review of literature and the study findings. In order to construct

a solid recommendation, I used support from change management theory and the research

related to the problem of nursing curriculum and changes, discussed in previous sections

of the research project. The theoretical undertones of change management guided the

construction of the policy paper. Scholars have considered Lewin (1930) the founding

father of the change process. Lewin (1951) developed a three-stage model of change,

known as the unfreezing-change-refreeze model, which requires exclusion of previous

learning and exchanged with new knowledge or ideas. Specifically, I utilized PET

(Baumgartner et al., 2007), an elaboration of change management theory, to guide

recommendations and understand the dynamics of the change process. This

understanding highlighted the importance of understanding previous contributions, power

dynamics, and stakeholder beliefs to propose change and promote its acceptance.

The problem addressed in this project was nursing curricular reform within the

parameters of performance on standardized accreditation exams, the current frame of

understanding success in nursing curricular reform. The NLN (2005) and the IOM

(2003) called for nursing education reform to meet the changing nursing environment,

and since then, nursing accrediting bodies have endorsed this movement. One promising

reform was concept-based curricula, which represents a significant departure from the

The change from a traditional content-based medical model to a concept-based

curriculum requires multiple significant adjustments and a collaborative environment;

thus, change management and PET were an appropriate choice to guide the construction

of policy related to these findings (Patria, 2012). Stakeholder’s flexibility during the

change process is necessary when proposing and implementing new ideas (Odagiu,

2012). A shared vision, flexibility, and self-reflection among all parties involved will

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